Claim total
$2,601.09
base $93.39 · payer covered $2,080.87
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2010-10-01
- Stop
- 2010-10-01
The parties
- Patient
- patient Jerrell Antwan Powlowski
- Provider
- provider Harold Hagenes
- Payer
- payer Anthem
Record id
3b2d7c05-6e2b-4868-96a9-d7a31dbc0a5e